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Britta M. Lundqvist, Eva Monestam; Long-time Results Of Cataract Surgery In Patients With Pseudo-exfoliations (PEX). Invest. Ophthalmol. Vis. Sci. 2011;52(14):4714.
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To prospectively investigate the long-term outcome of cataract surgery in patients with and without pseudoexfoliations (PEX), in a population-based cohort.
810 patients underwent small-incision phacoemulsification cataract surgery during a 1-year period. Data was collected before surgery and after 4 months, as well as 5 and 10 years postoperatively. At all occasions the patients had an eye examination and presence of PEX was recorded. The patients also answered a visual functional questionnaire (VF-14).
At baseline, 39% (315/810) of all patients were diagnosed with PEX. Patients with PEX were significantly older (P=.000) but no gender differences were found. Dense cataracts were significantly more common in the PEX-group (P=.000). Surgical complications was slightly more common in the PEX-group but the difference was not significant (P=.063). Ten years after surgery, 84% of the survivors (335/395) answered the questionnaire and 73% (289/335) had an eye examination as well. In this group, 29% (84/289) were diagnosed with PEX preoperatively. No differences regarding best corrected visual acuity of the operated eye, VF-14-results and frequency of YAG were found (age-adjusted). The intra-ocular pressure (IOP) was significantly higher in the PEX-group at all occasions (P<0.05). Four months after surgery, both the PEX group and the non-PEX group had a significant reduction of the IOP (Mean 1.6 and 1.2 mmHg, respectively, P=.000). After five years this significant IOP reduction was not sustained. At the 10 year follow-up the PEX group still had lower IOP compared with preoperatively. On the other hand, the non-PEX group had a higher IOP compared with preoperatively (P=0.06).
This study confirms that PEX is a common condition in Scandinavia. No differences regarding the subjective and objective visual functional results between patients with/without PEX could be found. Surgical complications were rare and not significantly more common in the PEX-group. The IOP was higher in the PEX group at all occasions. In eyes with PEX, cataract surgery may have a greater effect on the long-term reduction of IOP compared with non-PEX eyes.Patients with PEX can be advised that the visual prognosis in most cases is favourable also 10 years after surgery.
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